摘要
目的探讨痛风患者尿pH分布及影响因素,为痛风个体化治疗提供依据。方法本研究为回顾性研究,选取2019年9月至2021年8月于青岛大学附属医院痛风门诊就诊的患者,收集临床资料并测定相关指标,根据不同的尿pH值分组,比较各组间临床特点及尿pH值相关危险因素,采用SPSS 23.0软件进行统计分析。结果共入选2553例患者,不同尿pH组间的年龄、体重指数、三酰甘油、丙氨酸转氨酶(alanine aminotransferase,ALT)、血尿素氮、血肌酐、估算的肾小球滤过率(estimated glomerular filtration rate,eGFR)、血尿酸、尿尿酸/肌酐比值、尿酸排泄分数(fraction excretion of uric acid,FEUA),差异有统计学意义(F分别为5.114、4.772、7.170、4.721、13.603、2.812、3.422、22.834、18.230、26.332,均P<0.05)。急性期患者尿尿酸、FEUA高于缓解期患者(Z分别为-2.295,-3.528,均P<0.05)。校正性别、年龄、eGFR后,Logistics回归分析显示,体重指数、三酰甘油、总胆固醇、ALT、血尿酸和血尿素氮仍是酸性尿的危险因素。进一步进行多因素logistics回归分析显示,三酰甘油、血尿酸和血尿素氮是酸性尿的独立危险因素。线性相关分析显示,尿pH与体重指数、三酰甘油、总胆固醇、血尿酸、空腹血糖、血尿素氮、ALT呈负相关(r分别为-0.079、-0.106、-0.051、-0.186、-0.040、-0.122、-0.051,均P<0.05),与eGFR呈正相关(r=0.058,P=0.003)。结论原发性痛风患者整体尿pH值不达标,多种代谢组分和尿pH值有关,三酰甘油、血尿酸和血尿素氮是酸性尿的独立危险因素。临床中需关注,及时碱化尿液,预防并发症的发生。
Objective To investigate urinary pH distribution and its influencing factors in gout patients,to provide insights for individualized treatment.Methods This is a retrospective study.The gout patients in the Gout Outpatient Department of the Affiliated Hospital of Qingdao University from September 2019 to August 2021 were collected.Clinical data were collected and relevant indicators were measured.The patients were divided into different groups according to urinary pH.Clinical characteristics and factors related to urinary pH were compared among the groups.SPSS 23.0 software was used.Results A total of 2553 patients were enrolled.There were significant statistical differences in age,body mass index,triglyceride,alanine aminotransferase(ALT),blood urea nitrogen,serum creatinine,estimated glomerular filtration rate(eGFR),blood uric acid,urinary uric acid/creatinine ratio,fraction excretion of uric acid(FEUA)among groups with different urinary pH(F were 5.114,4.772,7.170,4.721,13.603,2.812,3.422,22.834,18.230,26.332,all P<0.05).Urinary uric acid and FEUA in acute group were higher than those in remission group(Z were-2.295,-3.528,both P<0.05).After adjusting for gender,age,eGFR,logistics regression analysis showed that body mass index,triglyceride,total cholesterol,ALT,blood uric acid,and blood urea nitrogen were still risk factors.Multivariate logistic regression analysis showed that triglyceride,blood uric acid,and blood urea nitrogen were independent risk factors associated with acid urine.Linear correlation analysis showed that urinary pH was negatively correlated with body mass index,triglyceride,total cholesterol,blood uric acid,fasting glucose,blood urea nitrogen,ALT(r were-0.079,-0.106,-0.051,-0.186,-0.040,-0.122,-0.051,all P<0.05),but positively correlated with eGFR(r=0.058,P=0.003).Conclusion The overall urine pH levels in patients with primary gout are below normal reference.Several metabolic components are related to it.Triglyceride,blood uric acid,and blood urea nitrogen are independent risk factors of acidic urine.In clinical practice,attention should be paid to timely alkalization of urine to prevent complications.
作者
马利丹
孙瑞霞
陈颖
程晓宇
刘甜
李长贵
王源
Ma Lidan;Sun Ruixia;Chen Ying;Cheng Xiaoyu;Liu Tian;Li Changgui;Wang Yuan(Department of Endocrinology and Metabolic Diseases,the Affiliated Hospital of Qingdao University,Qingdao 266003,China;Department of Neurology,the Affiliated Hospital of Qingdao University,Qingdao 266003,China)
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2024年第9期758-762,共5页
Chinese Journal of Endocrinology and Metabolism
基金
山东省自然科学基金项目(ZR2023MH167)。
关键词
痛风
尿PH
影响因素
Gout
Urine pH
Influencing factor
